Did you ever ponder why some obese people, after decades of being badgered by their families and physicians to lose weight, out-live their thin friends and seem perfectly healthy? Or how someone in his 50s falls over dead from a massive heart attack after being told during his check-up that everything was fine, his cholesterol perfect?
Despite the apparent injustice, this is not the devil’s work, but rather something associated with Satan—namely fire, or inflammation. Clues about inflammation began appearing some years ago when there seemed to be a connection between many of the chronic illnesses linked to aging–heart disease, diabetes, arthritis, and even dementia–and the amount of inflammation a person carried in her body.
Acute inflammation saves your life
Your body mounting what’s called an acute inflammatory response is a good thing…when you need it. And you need it to ward off any invader, whether it’s strep bacteria on your tonsils or a splinter in your thumb. During an acute response, a truly elegant radar system triggers the release of key chemicals just when and where they’re needed. The chemicals signal your blood to send troops of white blood cells to kill bacteria plus enzymes to clean up the battlefield. When you had that splinter your thumb became swollen and red. That was an acute inflammatory immune response and it’s a beautiful thing. Otherwise (really) the splinter could kill you.
However, picture your body’s acute inflammatory response coming with a label that reads “for emergency use only.”
Chronic inflammation is a whole different game
With chronic inflammation (inflamo is Latin for “I ignite”), your body is literally smoldering, cooking itself. Unfortunately, you don’t have much of a warning system that chronic inflammation is festering in your body, though some people are more sensitive to it than others. When my patients try to describe it, it’s really vague, like “I don’t know, doctor, something’s wrong, I feel inflamed.”
Other patients feel fine, and when they come in for a check-up have nothing to report. But slowly, over the years, this same person will develop conditions linked with chronic inflammation: high blood pressure, heart disease, diabetes, joint inflammation, digestive symptoms like reflux or colitis, and even dementia and cancers.
During the past year, numerous articles have appeared in medical journals analyzing inflammation and its consequences. This week, for example the Canadian Medical Association Journal (CMAJ) reported that healthy aging was impaired in people who had been diagnosed as chronically inflamed, indicated by high levels of what are called inflammatory markers. These markers are molecules circulating in your bloodstream that reflect increased inflammation.
You’ve probably heard of two of the oldest of these markers, the sed rate (ESR, or erythrocyte sedimentation rate) and C-Reactive Protein (CRP). Others include ferritin, fibrinogen, interleukin-6 (IL-6), and adiponectin. By tracing just one of these markers–IL-6–investigators noted that individuals with high levels aged poorly, developing many chronic illnesses and dying prematurely. The statement from the investigators sums it up: high inflammation “decreased likelihood for successful aging.”
A second study, published this week in the Journal of Clinical Endocrinology & Metabolism (JCEM), concluded that the reason some overweight people aged well, while others developed the chronic illnesses associated with obesity, was not the weight itself but rather the extent of individual body inflammation. Again, the last sentence of the article says it all. “Favorable inflammatory status is positively associated with metabolic health in obese and non-obese subjects.”
How can I tell if I’m inflamed?
Well, that’s one of the problems. Unless you get tested, you really can’t tell. However, if you’re living an unhealthful lifestyle, odds are that you’re chronically inflamed. Also, regardless your age, if you’ve got more symptoms (aches and pains, digestive, respiratory, fatigue) or are taking more medicines than friends your age, you should probably get tested for inflammatory markers. People who have a medicine chest filled with steroid skin creams, asthma inhalers, Nexium-type meds to reduce acid, and NSAIDs for body aches are also likely chronically inflamed.
When it comes to chronic inflammation, lifestyle choices are highly influential. You’re increasing the level of inflammation in your body if:
- You smoke.
- You don’t exercise regularly.
- You eat a nutritionally poor diet rife with refined flour, sugar, animal fats, and processed foods filled with additives, chemicals, and preservatives.
- You’re stressed out.
- You’ve got some hidden food sensitivities (gluten is a big villain here).
- You have chronic, low-level infections from bacteria, parasites, candida, or viruses.
- Your teeth are in bad shape and you don’t floss (dental plaque is a constant source of inflammation).
- You have chronically inflamed skin that constantly requires steroid creams to reduce its redness.
How can you test for inflammation in your body?
The simplest single blood test you can ask your physician to order to assess the inflammatory status in your body is the CRP (translated as the high-sensitivity C-reactive protein test). This should be covered by your health insurance, but if not should cost no more than $70.
If you have health insurance of the PPO type (not HMO), Health Diagnostic Lab (HDL) offers a spectrum of tests in a single blood draw that evaluates your cholesterol profile (including particle size), several inflammatory markers, diabetes risk factors, metabolic markers, and your fatty acid profile (including whether you’re getting enough omega 3s).
What I like about this comprehensive test is that once you’ve met your annual insurance deductible, HDL accepts whatever your insurance pays them and won’t bill you for the difference. If you have no insurance or are HMO (essentially self-pay), they offer a very substantial discount ($378 for the whole kit). If you’re not a WholeHealth Chicago patient, simply tell your doctor about these labs. HDL will mail her a kit for your blood draw and she can FedEx your specimen to them overnight.
What you can do to minimize inflammation
Just do the opposite of everything listed in the unhealthful bullet points:
- Eat a nutritious diet of whole foods with plenty of fresh fruits and vegetables (which themselves are anti-inflammatories). Avoid processed foods, refined-flour products (this list is enormous, including most breads, pastas, cookies, cakes, and pies), and sugar (ditto the enormous list). Go gluten-free for a couple weeks and if you feel a lot of your chronic symptoms disappear, only to return when you re-introduce gluten, best stay off it forever.
- Eat more fish for their omega 3s and switch to healthy fats like olive oil.
- Exercise regularly. This alone can lower your inflammatory markers.
- Reduce stress. Learn meditation, do yoga, avoid being a lawyer in a big law firm or a human resources manager in a big corporation (I think Somali pirates have less stressful jobs than these two).
- Stop smoking (I can’t believe I still have to tell people to do this).
- Get your teeth cleaned and fixed. Then brush and floss them every day.
- Helpful supplements include a probiotic to heal the lining of your intestines, natural anti-inflammatories like turmeric, and boswelia, fish oil, and bioflavonoids.
Reducing your body’s inflammatory load is turning out to be the most significant step you can take for a healthy long life. Get started!
David Edelberg, MD